生物骨科材料与临床研究2018，Vol.15Issue(3)：29-32,4.DOI:10.3969/j.issn.1672-5972.2018.03.007
微创前路钢板内固定技术治疗不稳定性骨盆骨折
Treatment of the unstable pelvic fracture with minimally invasive plate fixation by under iliopsoas approach
刘勇 1李浩 1李楠 1杨扬 1赵德勇 1郭含军1
作者信息
- 1. 徐州医科大学附属医院骨科,江苏 徐州,221006
- 折叠
摘要
Abstract
Objective To explored the feasibility of plate fixation by anterior mini-open approach in treatment of the unstable pelvic fracture and evaluate its therapeutic effects. Methods From Feb 2009 to Aug 2016,20 patients with closed unstable pelvic fractures were treated withminimally invasive plate technique. There were ninemales and eleven females, average age 38. 5 years. 11 patients were type B, 9 patients of type C according to Tile classication. The anterior pelvic ring fractures included unilateral pubic ramus fractures in eleven patients and bilateral pubic ramus fractures in nine. Fourteen patients had sacrum fracture or sacroiliac joint dislocation. The anterior pelvic rings were fixed with minimally invasive reconstruction plates through two incisions, and the posterior pelvic rings fixed with percutaneous sacroiliac joint screws fixation or mini-open plate fixation technique. Intraoperative blood loss and operation time were measured. The quality of reduction and postoperative functional outcomes were assessed by Matta criterion and Majeed scoring system respectively. Results The average operation time and intraoperative blood loss by the anterior approach was 1 hour and 215 mL respectively. All the patients obtained followed up an average 26 months, which showed that all patients got satisfactory reductions and that the fractures were healed at one stage, with average period of 11 to 14. 5 weeks. There occurred no infections, failures of internal fixations or nerve injuries. According to Majeed standard of pelvic injury function assessment, the result was excellent in 15 patient, good in three and with fair in two. The quality of reduction according to Matta criteria was graded as excellent in 17, good in 2 and moderate in 1. One patient with sacroiliac joint fracture and sacral nerve injury show obvious gait irregularity and disturbance of sensation operation. Conclusion Under master of the pelvic anatomy and surgical indications, minimally invasive plate technique takes advantages of minor trauma, short operation time, good curative results and few complications in treatment of the unstable pelvic fractures without the necessity to dissect neurovascular structure.关键词
骨盆骨折/骨折固定术/微创Key words
Pelvis fracture/Fracture fixation/Mini-open分类
医药卫生引用本文复制引用
刘勇,李浩,李楠,杨扬,赵德勇,郭含军..微创前路钢板内固定技术治疗不稳定性骨盆骨折[J].生物骨科材料与临床研究,2018,15(3):29-32,4.
